Instructions
Domestic violence is a crime! It comes in many forms. It includes any or all of the following acts by a current or former intimate partner, relative or household member:
- physical abuse, such as pushing, hitting, shoving, kicking, biting, choking;
- being forced to have sex;
- threats of physical or sexual abuse; or
- serious emotional abuse.
You may be excused from certain Transitional Aid to Families with Dependent Children (TAFDC) program requirements if you or your children have been hurt by domestic violence, and meeting one or more of these requirements may hurt you or your children. When you ask to be excused from a requirement, you are asking for a "waiver." You may receive a waiver if a requirement:
- might lead to you or your child(ren) being physically or emotionally harmed by domestic violence;
- makes it harder for you or your child(ren) to escape the domestic violence; or
- unfairly penalizes you or your child(ren) because of past domestic violence.
To help the Department decide if you are eligible for a waiver, you must answer the questions on this form. Attach more paper if you need to. Try to give as much information as possible.You will be asked to give dates when the domestic violence happened. If you can't remember the exact dates, write the month and the year you think is correct. You will also need to attach some proof. (Examples of proof are on the last page of this form.)
To get a waiver, you must show two things:
- that you or your child(ren) have suffered from domestic violence; and
- why the domestic violence you or your child(ren) experienced makes it difficult for you to meet the requirement; or
- in the case of the family cap rule, that the child born after your family cap date was conceived as a result of the domestic violence.
You may ask one of the Department's Domestic Violence Specialists (DVS), your worker or a battered women's program for help answering these questions or getting the proof you need. You may also ask your worker for the names and phone numbers of people who can help you, or you may take the form home with you to complete. The Department understands how hard it can be to tell others about what happened to you and your child(ren); however, Department of Transitional Assistance (DTA) staff have been trained to be aware of domestic violence and its effects on families, and will treat you with understanding and respect.
Attention
Please be sure you have read this page or that it has been read to you before completing the Request for Waiver of TAFDC Program Requirements due to Domestic Violence form.
Produced by Massachusetts Department of Transitional Assistance Created February 2001
